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Effect of Optimal Biological Volume Bupivacaine Liposome Interscalene Brachial Plexus Block on Postoperative Analgesia After Shoulder Arthroscopy

27. august 2026 opdateret af: Qing-he Zhou, Affiliated Hospital of Jiaxing University
This study aims to evaluate whether 15ml/75mg low-dose bupivacaine liposome is non-inferior to 15ml/133mg standard-dose bupivacaine liposome for postoperative analgesia in interscalene brachial plexus block during arthroscopic shoulder surgery, through a single-center, prospective, double-blind, non-inferiority randomized controlled clinical trial. It will also assess whether 15ml/75mg low-dose bupivacaine liposome is superior to 15ml/133mg standard-dose bupivacaine liposome in terms of diaphragmatic excursion, pulmonary function, duration of block effect, and nerve block-related adverse reactions during interscalene brachial plexus block.

Studieoversigt

Detaljeret beskrivelse

This study is designed as a single-center, prospective, double-blind, non-inferiority randomized controlled clinical trial, to evaluate and compare whether the postoperative analgesic efficacy of 15 mL/75 mg low-dose liposomal bupivacaine for interscalene brachial plexus block in patients undergoing shoulder arthroscopy is non-inferior to that of 15 mL/133 mg standard-dose liposomal bupivacaine, and to further assess whether the low-dose regimen demonstrates advantages over the standard-dose counterpart in terms of diaphragmatic excursion, pulmonary function, duration of block effect, and nerve block-related adverse reactions.

Undersøgelsestype

Interventionel

Tilmelding (Anslået)

40

Fase

  • Ikke anvendelig

Kontakter og lokationer

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Studiesteder

    • Zhejiang
      • Jiaxing, Zhejiang, Kina, 314000
        • Jiaxing University Affiliated Hospital

Deltagelseskriterier

Forskere leder efter personer, der passer til en bestemt beskrivelse, kaldet berettigelseskriterier. Nogle eksempler på disse kriterier er en persons generelle helbredstilstand eller tidligere behandlinger.

Berettigelseskriterier

Aldre berettiget til at studere

  • Voksen
  • Ældre voksen

Tager imod sunde frivillige

Ingen

Beskrivelse

Inclusion Criteria:

  • Patients aged 18 years or older.
  • ASA classification I-III.
  • Arthroscopic shoulder rotator cuff repair, capsular plication, acromioplasty, synovectomy, etc.

Exclusion Criteria:

  • Have a history of lung disease.
  • Coagulation dysfunction or coagulopathy.
  • History of allergy to local anesthetics.
  • infection or lesions at the block site; or history of cervical spine disease.
  • pregnancy.
  • Refusal to participate in the study or inability to communicate.
  • Long-term use of opioids.
  • Body mass index >35 kg/m2
  • Previous history of nerve injury, paralysis, or paresis;

Studieplan

Dette afsnit indeholder detaljer om studieplanen, herunder hvordan undersøgelsen er designet, og hvad undersøgelsen måler.

Hvordan er undersøgelsen tilrettelagt?

Design detaljer

  • Primært formål: Forebyggelse
  • Tildeling: Randomiseret
  • Interventionel model: Parallel tildeling
  • Maskning: Firedobbelt

Våben og indgreb

Deltagergruppe / Arm
Intervention / Behandling
Eksperimentel: OBV bupivacaine liposome group
Following our preliminary study protocol, 13 mL of liposomal bupivacaine (derived from the 20 mL/266 mg commercial formulation) is aspirated and further diluted with 0.9% sodium chloride injection to a final total volume of 53 mL while maintaining the fixed total dose of 266 mg. This diluted preparation is then combined with 2 mL of 0.5% conventional bupivacaine, and the resultant 55 mL mixture is administered to perform interscalene brachial plexus block prior to surgical incision.
Following our preliminary study protocol, 13 mL of liposomal bupivacaine (derived from the 20 mL/266 mg commercial formulation) is aspirated and further diluted with 0.9% sodium chloride injection to a final total volume of 53 mL while maintaining the fixed total dose of 266 mg. This diluted preparation is then combined with 2 mL of 0.5% conventional bupivacaine, and the resultant 55 mL mixture is administered to perform interscalene brachial plexus block prior to surgical incision.
Eksperimentel: Standard dose bupivacaine liposome group
Following the recommendations in published literature and the approved product labeling, 10 mL of liposomal bupivacaine (20 mL/266 mg formulation) is aspirated, combined with 2 mL of 0.5% conventional bupivacaine, diluted to a final total volume of 15 mL with 0.9% sodium chloride injection, and administered to perform ultrasound-guided interscalene brachial plexus block prior to surgical incision.
Following the recommendations in published literature and the approved product labeling, 10 mL of liposomal bupivacaine (20 mL/266 mg formulation) is aspirated, combined with 2 mL of 0.5% conventional bupivacaine, diluted to a final total volume of 15 mL with 0.9% sodium chloride injection, and administered to perform ultrasound-guided interscalene

Hvad måler undersøgelsen?

Primære resultatmål

Resultatmål
Foranstaltningsbeskrivelse
Tidsramme
Difference in numeric rating scale scores for resting pain at 24 hours after surgery
Tidsramme: postoperative 24 hours
Difference in numeric rating scale scores(0 = no pain, 10 = worst pain; higher numbers indicate greater pain intensity) for resting pain at 24 hours after surgery. Postoperatively, the NRS scale was used to evaluate pain scores.
postoperative 24 hours

Sekundære resultatmål

Resultatmål
Foranstaltningsbeskrivelse
Tidsramme
Total consumption of morphine milligram equivalents within 72 hours postoperatively
Tidsramme: within 72 hours postoperatively
Record opioid analgesics within 72 hours postoperatively, convert to morphine equivalent dose, and calculate the total amount.
within 72 hours postoperatively
Differences in numeric rating scale pain scores at rest and during activity within 0.5 hours, 6 hours, 24 hours, 48 hours, and 72 hours postoperatively
Tidsramme: postoperative 0.5 hours, 6 hours, 24 hours, 48 hours, 72 hours
Differences in numeric rating scale (0 = no pain, 10 = worst pain; higher numbers indicate greater pain intensity) pain scores at rest and during activity within 0.5 hours, 6 hours, 24 hours, 48 hours, and 72 hours postoperatively. Postoperatively, the NRS scoring scale was used to assess pain scores.
postoperative 0.5 hours, 6 hours, 24 hours, 48 hours, 72 hours
Complete unilateral HDP during quiet breathing at 0.5 hours 6 hours, and 24 hours after completion of block
Tidsramme: postoperative 0.5 hours, 6 hours and 24 hours
A diaphragm excursion of >75% on the blocked side measured under ultrasound is defined as complete unilateral hemidiaphragmatic paralysis (HDP).
postoperative 0.5 hours, 6 hours and 24 hours
Pulmonary function
Tidsramme: postoperative 0.5 hours, 6 hours and 24 hours
Use a portable respiratory function tester for bedside testing; have the patient blow three times and take the average.
postoperative 0.5 hours, 6 hours and 24 hours
All adverse events related to surgery and anesthesia occurring within 72 hours postoperatively
Tidsramme: within 72 hours postoperatively
Adverse events associated with nerve blocks within 72 hours postoperatively, including pneumothorax, intravascular injection, local anesthetic toxicity, and Horner syndrome, were recorded.
within 72 hours postoperatively
The number of rescue analgesic interventions required within 72 hours postoperatively
Tidsramme: within 72 hours postoperatively
The number of analgesic administrations within the first 72 hours postoperatively was recorded.
within 72 hours postoperatively
sensorimotor score
Tidsramme: postoperative 0.5 hours, 6 hours and 24 hours
After completion of the block, the simplified sensorimotor assessment scale (3-point method) is used for evaluation, and a total sensorimotor score ≥12 points with a total sensory score ≥3 points is defined as successful brachial plexus block.
postoperative 0.5 hours, 6 hours and 24 hours

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Datoer for undersøgelser

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Studer store datoer

Studiestart (Anslået)

1. september 2026

Primær færdiggørelse (Anslået)

1. september 2028

Studieafslutning (Anslået)

1. september 2028

Datoer for studieregistrering

Først indsendt

23. august 2026

Først indsendt, der opfyldte QC-kriterier

27. august 2026

Først opslået (Faktiske)

28. august 2026

Opdateringer af undersøgelsesjournaler

Sidste opdatering sendt (Faktiske)

28. august 2026

Sidste opdatering indsendt, der opfyldte kvalitetskontrolkriterier

27. august 2026

Sidst verificeret

1. august 2026

Mere information

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